Healthcare Provider Details

I. General information

NPI: 1538011291
Provider Name (Legal Business Name): ROBERTO JOSE QUINONES FLORES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PORTLAND AVE STE 240
ROCHESTER NY
14621-3022
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-3260
  • Fax: 585-922-3261
Mailing address:
  • Phone:
  • Fax: 585-922-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433535
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: